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Organization
KNEALSKI PERSONAL CARES SERVICES, LLC
Active
Organization
KNEALSKI PERSONAL CARES SERVICES, LLC
Active
Other names
KNealski Personal Cares Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE M HARRIS (PROGRAM ADMINISTRATOR)
(414) 507-2975
Entity
Organization
Contact information
Practice address
4427 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3444
(414) 585-0308
(414) 763-7834
Mailing address
3708 N 50TH ST, MILWAUKEE, WI 53216-2933
(414) 507-2975
(414) 763-7834
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001161962
—
WI
Enumeration date
04/09/2020
Last updated
04/09/2020
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